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YEAR 4 - DIGESTIVE > Liver general - Kumar > Flashcards

Liver general - Kumar Flashcards

1
Q

What is cirrhosis?

A
  • Represents the final common pathway for liver diseases
  • Characterised by progressive fibrosis of the liver parenchyma –> portal hypertension and deterioration of liver function.
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2
Q

What is the median survival of decompensated cirrhosis?

A

• 2 years

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3
Q

What are the clinical signs of liver disease?

A
  • General: encephalopathy / weight loss
  • Eyes: jaundice / Kayser-Fleisher rings (Wilson’s disease) / Xanthelasma
  • Parotid swelling
  • Spider naevi
  • Gynaecomastia
  • Abdomen: scars / ascites / dilated superficial veins / hepatomegaly / splenomegaly / tumour / palpable gall bladder
  • Hands: flapping tremor / palmar erythema / dupuytren’s contracture / clubbing / leuconychia
  • Testicular atrophy
  • Excoriations
  • Oedema
  • Bruises
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4
Q

What are the functions of the liver?

A
  • Protein synthesis
  • Metabolism
  • Immune
  • Storage
  • Excretion
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5
Q

What proteins does the liver synthesise?

A
  • Albumin
  • Coagulation factors
  • Transferrin
  • Protein inhibitors (alpha1-antitrypsin)
  • Complement
  • Haptoglobin
  • Caeruloplasmin
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6
Q

What does the liver metabolise?

A
  • Carbohydrates (glycogen)
  • Protein
  • Lipids
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7
Q

How is the liver involved in the immune system?

A
  • Kupffer cells

* Innate factors

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8
Q

What is stored in the liver?

A
  • Iron
  • Copper
  • Vitamins A, D, B12
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9
Q

What is excreted by the liver?

A
  • Bile salts
  • Bilirubin
  • Phospholipids
  • Cholesterol
  • Drugs
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10
Q

Describe the liver biochemistry tests.

A
  • Hepatocytes: ALT (alanine transferase) / AST (aspartate transferase) / gammaGT (gamma glutamyl transpeptidase)
  • Bile canalicular membranes: ALK (alkaline phosphate)
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11
Q

What are the liver function tests?

A
  • Albumin

* Prothrombin time

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12
Q

What should be felt for when palpating the liver?

A
  • The liver edge:
  • Is it smooth or irregular?
  • Knobbly?
  • Tender?
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13
Q

How does the liver move on inspiration?

A

• Downwards

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14
Q

How does the spleen move on inspiration?

A

•Downwards and to the right towards right iliac fossa

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15
Q

List the common viral tests for acute liver disease

A
  • HBsAG / IgM anti-HBc
  • IgM HAV
  • Anti-HEV
  • Anti-HCV
  • Cytomegalovirus
  • Epstein-Barr
  • Herpes simplex
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YEAR 4 - DIGESTIVE (8 decks)

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